The McDonough County Board's finance committee Wednesday asked for a cost comparison before deciding on the possibility of adding federal Affordable Care Act exchanges as an option in the county healthcare plan.

Insurance agent Keith Krohe said he would solicit insurance carrier renewal costs with and without the ACA option.

Krohe said open enrollment for the January rollout of the Affordable Care Act begins Oct. 1 and runs through Dec. 15. He said a subsequent open enrollment period would begin in March.

"It's not a government-run plan in Illinois," Krohe said, indicating the Illinois exchanges would be public/private partnerships. He said employees or family members with chronic or catastrophic conditions paying in excess of $50,000 in medical costs might fare better on the exchanges.

"They could do this because there would no longer be restrictions on pre-existing conditions," the insurance agent said. Krohe said employees would always have the option to return to the county plan if they weren't satisfied with the optional policy.

"It sounds like a happy medium to me to make the exchanges optional and not required …" said committee member Matt McClure. "It might be to the best benefit of someone with a chronic illness to opt for this because their costs would be reimbursable."

Insurance broker Randy Pickering added, "The only reason a person who's enrolled in an employee medical plan would go to the exchanges is to get a subsidy."

The committee voted to recommend adoption of new healthcare confidentiality requirements between the county and its agents and health providers. Affordable Care Act regulations require new language in the agreements.

Krohe reported that total county health care plan costs through August were $1.59 million, compared to $1.63 million last year at this time. He said adding the HealthLink Network for employees needing Springfield-area medical referrals has yielded discounts such as 64 percent of hospital charges and 56 percent of physician charges.

Other business

The committee also discussed the 2014 budget outlook for four areas. Veterans Assistance Superintendent Rick Smart has consistently declined any salary increase, and said he is building a surplus in his veterans aid account.

Smart said the number of veterans seeking financial assistance each month has climbed from seven or eight a month to between 13 and 15.

Sandy Nelson, chair of the 708 Mental Health Board, said county funding is essential in light of cuts at the state and federal levels.

Maggie Banks of North Central Behavioral Health Systems said, "Some of the money from McDonough County helps with crisis intervention and with some community involvement activities."

Regional School Superintendent John Meixner said McDonough County would pay 58 percent of his office costs next year and Hancock County would pay 42 percent.

Page 2 of 2 - "The counties pay for our basic office funding and we build on that with grants," he said.

Meixner has two office employees in his Macomb office and a halftime employee in his Carthage office. He said he's seeking a 3.7 percent budget increase.

County Resident Judge Bill Poncin said the main changes for 2014 would be an increase in funding available for court-appointed attorneys and a decrease in funding for the law library.

"Most legal research is done online," he said. "I want to talk with the McDonough County Bar Association about what it sees as the future of the law library."

Poncin turned to the current judicial budget, saying he foresees shortfalls in office supplies, the secretarial budget, and in the court-appointed attorney fund. The committee voted to recommend transfers to cover the first two funds.

The judge said he might need another $10,000 for the court-appointed attorneys, and the committee indicated that amount may be transferred later from the county's contingency fund.

County Clerk Gretchen DeJaynes said an Illinois Municipal Retirement Fund assessment of $5,400 would have to be paid. This is because, with the inclusion of vacation and sick days, one 2012 retiree earned six percent above her 2011 salary.

DeJaynes said the county's obligation to IMRF was 6.25 percent of employee contributions in 2006, but that it is now 11.95 percent.